CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

June 3rd, 2013

Waiting For ATP IV In Las Vegas

May 31– Today was the first full day of the National Lipid Association meeting in Las Vegas, Nevada. As a first time attendee, I notice many differences compared to the larger meetings. Firstly, there are ~ 700 people in attendance; this dwarfs in comparison to the AHA and ACC which count attendees in the thousands. As a fellow I appreciate the more intimate and collegial atmosphere; it allows for more opportunities to meet and connect with others who share similar interests and with leaders in the field. I also realized the true collaborative nature of the fields of lipidology and prevention, with its diverse roster of attendees from cardiology, internal medicine, endocrinology, pharmacy, and more.

The most crowded session of the day featured Neil Stone, from Northwestern University. As the chair of the ATP IV panel he gave a talk titled “Preparing for guidelines in 2013.” The room was packed full of people, likely looking for some small glimpse into the upcoming guidelines that have met with years of delay.

The main focus of the talk was on the importance of using strong evidence to make recommendations– mostly high-quality randomized clinical trials and meta-analyses of RCT’s, and why this is important. He briefly reviewed the evidence behind statins. He said that the guidelines will address statin side effects, but did not specify a position. Unfortunately, he was unable to provide a timeline for the release of these highly anticipated recommendations.

During the Q&A session, one attendee inquired about treating to LDL targets <70; interestingly, Dr. Stone responded that the data behind “lower is better” is actually debatable. Those who had lower LDL’s in the trials actually started at a lower LDL and may have had lower risk to begin with. Stone did not take a position either way on whether he supported “lower is better.”

So there were only a few slight hints of what to expect…unfortunately we will still have to wait (a little?) longer.

What are your thoughts on what to expect in ATP IV? Why do you think it is taking so long to be released?